Quadrant微创系统治疗腰椎退行性疾病的临床疗效观察

Clinical efficacy of treatment of lumbar degenerative disease under the Quadrant minimally invasive treatment system

[目的]探讨应用Quadrant微创系统治疗腰椎退行性疾病的临床疗效。[方法]对2011年2月～2012年4月本院应用Quadrant微创系统行腰椎融合手术患者34例进行分析,观察手术后各项指标、椎间隙高度恢复及并发症发生情况,并采用日本骨科学会(JOA)评分和疼痛视觉模拟量表(VAS)评分评估临床疗效。[结果]34例患者的平均手术时间为174 min,平均手术切口长度为4.2 cm,平均术中出血量252 ml,平均术后引流量97 ml,平均术后下地活动时间为1.9 d,平均术后住院时间为7.6 d。术后出现并发症1例,为一过性神经根刺激症状,经处理后症状消失。所有患者平均随访时间为11.8个月,统计分析显示出院前及末次随访时的JOA、腰腿痛VAS评分与术前相比明显改善,差异有统计学意义(P<0.01),末次随访时生活质量改善率平均为85.6%,椎间隙高度从术前(5.68±1.82)mm增至(10.01±1.31)mm。[结论]应用Quadrant微创系统治疗腰椎退行性疾病具有对腰椎稳定性破坏小、组织损伤轻、出血少、术后恢复快等优点,且操作简单,临床疗效确切,值得临床推广。

[ Objective ] To investigate the clinical efficacy of applying the Quadrant minimally invasive treatment system for the treatment of lumbar degenerative disease. [ MethodI From February 2011 to April 2012,34 patients treated with lumbar fu- sion under Quadrant minimally invasive treatment system were analysed. The postoperative indexes, the intervertebral height re- covery and complications were recorded. The clinical efficacy was evaluated according to the Japanese Orthopaedic Association （JOA） scores and visual analogue scale（VSA） scores. [ Result] The average operation time was 174 min, the incision length was 4.2 era, surgical blood loss was 252ml, surgical draining loss was 97ml, the postoperative ambulation time was 1.9 d, the hospital stay was 7.6 d. Complication was noted in one patient ,which was the transient nerve root irritation symptom and ceased after treatment. The mean follow-up was 11.8 months. The JOA scores and the lumboerural pain VSA scores before discharge and of the final follow-up improved than that of preoperation ,and the difference was statistically significant（ P 〈 0.01 ）. The av- erage improvement rate of life quality was 85.6% at final follow-up. The intervertebral height increased from（ 5.68 ± 1.82 ） mm to（ 10.01 ±1.31 ） mm. [ Conclusion] Applying the Quadrant minimally invasive treatment system to treat the lumbar degenera- tive disease has many advantages such as less damage to the spine stability,less tissue trauma,less bleeding and quicker recov- ery and so on, beside of those advantages,it is easy to operate and has defined clinical efficacy. All of these suggest the clinical promotion.